Long-term Follow up after Molar Root Canal Retreatment

Mr. Qu has occasional toothache after a filling falls out of a molar.  X-ray shows that this 2nd molar (Fig.1: #2) has incomplete root canal (*).  The lower end of root canal filling (black <) does not reach the end of the roots (white <).  This suggests that some of nerve is not completely removed. leaving germs behind.  Root canal needs to be redone.  First of all, the 3rd molar (#3 in Fig.1) behind the 2nd molar should be extracted to make room for the 2nd molar crown.

Molar root canal redo is usually difficult.  Old root canal filling should be removed (Fig.2 *).  The remaining nerve is then cleaned up by insertion of a fine file (three of <).  Following these three arrowheads, you may realize the canal is tortuous.

Finally new root canal filling is done (Fig.3: three of <, also following the curvature of the canal).  The new filling is thicker and longer than before (Fig.1) to insure that germs are ridden of.  The 3rd molar is gone now (3).  

For the next five years, Mr. Qu is pain free.  He returns to our dental office to re-cement the crown over the 2nd molar.  The root tip infection (Fig.2,3: white *) appears to be gone now (Fig.4).  The 3rd molar socket heals completely (3).

Xin Wei, DDS, PhD, MS 1st edition 09/06/2012, last revision 09/06/2012